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PubMed1998

The effects of Florida's Medicaid eligibility expansion for pregnant women.

OBJECTIVES: This is a study of the effects on prenatal care and birth outcomes of Florida's July 1989 expansion in the Medicaid income eligibility threshold for pregnant women. METHODS: Concurrent and longitudinal comparisons were performed with matched birth and death certificates, hospital discharge data, Medicaid eligibility records, and records from county health departments for women giving birth from July 1988 to June 1989 (n = 56,101) or in calendar year 1991 (n = 78,421). Measures included amount and timing of prenatal care and rates of low birthweight and infant deaths. RESULTS: The Medicaid expansion led to greater access and improved birth outcomes. For example, the rate of low-birthweight infants among low-income women without private insurance fell from 67.9 to 61.8 per 1000, while it remained unchanged for low-income women with private insurance. Women in the expansion group who used county health departments had fewer low-birthweight infants than those using other delivery systems. CONCLUSIONS: The benefits from the Florida expansion appear to be greater than those reported for other states. The role of the public health delivery system may account for some of Florida's success.

Eligibility Determination↗
PubMed2006

Source reduction in Florida's salt marshes: management to reduce pesticide use and enhance the resource.

Source reduction as part of an integrated pest management program is a cornerstone of the American Mosquito Control Association's Pesticide Environmental Stewardship Program Strategy Document to reduce pesticide risk. Since the early 1980s, Florida has made important strides in implementing environmentally sound source reduction strategies in salt marshes while managing them for both mosquito control and natural resource enhancement. The political mechanism for this progress has been interagency cooperation through the Florida Coordinating Council on Mosquito Control and its Subcommittee on Managed Marshes. Challenges in accomplishing source reduction continue because both public and private lands are involved. Public lands include those owned by federal (e.g., U.S. Fish and Wildlife Service, National Park Service), state (Florida Department of Environmental Protection), and local governments, and they have a diversity of management objectives. This diversity adds to the challenge facing mosquito control agencies in providing mosquito control services while protecting and enhancing the environment.

Conservation of Natural Resources↗
PubMed1995

Effects of interrelationships of production and reproduction on net returns in Florida.

Economic aspects of reductions in reproductive efficiency associated with increased production of milk and fat were evaluated for Holsteins and Jerseys in Florida during warm and cool seasons. Net returns from sire selection for increased production were examined with and without incorporation of such negative effects. The economic framework is the application of risk analysis in portfolio selection to selection of dairy sires. Estimates of effects of production on reproduction were from an earlier study of 4293 Holstein and 2143 Jersey cows in first lactation on 14 Florida dairy farms in warm and cool seasons. The scenario represented the typically low reproductive efficiency of cows, especially Holsteins, during summer in Florida, although some statistics used represented US values. Least squares estimates of net returns after adjustment for reproductive losses showed major reductions in net returns for both breeds for both seasons, for example, $28 to $30/yr per lactation, representing 47 to 53% of predicted net returns for Holsteins and 27 to 31% for Jerseys. The results also suggested that increased use of young sires, which results generally in higher conception rates and lower semen costs, might be justified in tropical and subtropical areas, particularly during hot seasons.

Aging↗
PubMed1984

A survey of filariasis among refugees in south Florida.

Between January 1981 and March 1982, a filariasis survey was conducted among 668 Haitian immigrants and 155 Southeast Asian refugees residing in Florida, U.S.A. Microfilariae were detected only in Haitians, with 6.7% positive for Wuchereria bancrofti and 1.3% positive for Mansonella ozzardi. The majority of individuals with bancroftian filariasis came from five coastal urban areas including Port-au-Prince, Duvalierville, Gonaïves, Leógane and Cap-Haitien. No unequivocal signs of bancroftian filariasis or mansonellosis were seen. Membrane feeding of several species and strains of laboratory-reared mosquitoes on blood from a volunteer microfilaremic with W. bancrofti showed that Aedes aegypti and A. taeniorhynchus, but not Culex quinquefasciatus, were susceptible to infection with the Haitian strain of W. bancrofti. Culicoides furens, a known vector of M. ozzardi in Haiti and present in Florida, was not tested. Further studies are needed to determine the competence of Florida vectors for transmitting W. bancrofti and M. ozzardi to the indigenous human population.

Adolescent↗
PubMed1984

Ixodid ticks on feral swine in Florida.

More than 99% of the 645 feral swine (Sus scrofa L.) in southern Florida harbored ixodid ticks. Dermacentor variabilis (American dog tick) was present on 99.6% of the swine and comprised 82.5% of the ticks collected. Amblyomma maculatum (Gulf Coast tick) occurred on 85.9% of the hosts and 17.4% of the collections were of this species. Amblyomma americanum (Lone Star tick) and Ixodes scapularis (Black-legged tick) were found infrequently and together constituted less than 0.1% of the ticks. Pigs were infested by 7-22 days of age and 95% carried ticks by 6 wk of age. Only adult ticks were found on swine from southern Florida, but immature stages of A. americanum were present from a small sample of swine from northern Florida. Each species had a different pattern of distribution on the feral swine. No Ornithodoros species were found among the 36,616 ticks collected from feral swine during this survey.

Animals↗
PubMed1993

Morphology, prevalence, and distribution of Sarcocystis spp. in white-tailed deer (Odocoileus virginianus) from Florida.

Three morphologically distinct types of sarcocysts (I, II, and III) were identified by light microscopy in tongues from 403 white-tailed deer (Odocoileus virginianus) collected in Florida (USA) over a 7-yr-period. Based on electron microscopy of representative examples of these sarcocysts, there were four distinctive wall structures. We concluded that one of these (Type I) was representative of Sarcocystis odocoileocanis and another (Type III) was representative of an unnamed species previously described from white-tailed deer in Montana. Type II could be divided further into two forms (IIA and IIB) that may represent two underscribed species or developmental stages of the same species. Sarcocystis odoi, another previously recognized sarcosporidian from white-tailed deer, was not found. Sarcocysts of Types I and II were distributed nonrandomly in tongue muscle, being more common in the basal portion, whereas Type III was distributed randomly throughout the tongue. Single infections (one of the three types) accounted for 63% of the infected deer, while double infections occurred in 28% and triple infections in 4%. Types I and II were found in deer throughout the state, but Type III occurred only in deer from southern Florida. In 1988 and 89, the statewide prevalences for Types I, II, and III were 57, 20, and 6%, respectively. Prevalences of Type I ranged from 94% in the panhandle region (northern Florida) to 34% in the southern part of the state. Prevalences of all three types increased with age.

Age Factors↗
PubMed1995

Antibodies to St. Louis encephalitis virus in armadillos from southern Florida.

From January 1990 through March 1991, 189 armadillos (Dasypus novemcinctus) were collected from Brevard and Glades Counties in southern Florida (USA). The sera were analyzed for hemagglutination-inhibition (HAI) antibodies against St. Louis encephalitis (SLE) and eastern equine encephalomyelitis (EEE) viruses. None of the armadillos had detectable HAI antibody to EEE virus, but 59 (31%) had antibodies against SLE virus. Sera from 31 of the HAI-positive armadillos contained significant levels of neutralizing (NT) antibody to SLE virus. Armadillos captured during the 1990 SLE human epidemic in south Florida had a greater prevalence of HAI and NT antibody to SLE virus than did animals captured before the start of the epidemic. This is evidence that armadillos were fed on by mosquitoes infected with SLE virus. We propose that armadillos may be involved in the SLE amplification and transmission cycles in Florida.

Animals↗
PubMed1995

Notoedric mange in the Florida panther (Felis concolor coryi).

Notoedric mange (Notoedres cati) was found in a neonate Florida panther (Felis concolor coryi) and presumably its mother on 22 June 1992 and 8 February 1993, respectively, in Collier County, Florida (USA). Both infestations were treated successfully with 0.2 mg/kg ivermectin. This is the first known case of notoedric mange in the endangered Florida panther.

Animals↗
PubMed1995

Ixodid ticks from panthers and bobcats in Florida.

Ixodid ticks were present in all 189 samples examined from 53 Florida panthers (Felis concolor coryi, 104 collections) and 85 bobcats (Felis rufus floridana) in Florida (USA) between 1974 and 1991. We identified 3,251 ticks from panthers and 918 from bobcats. Specimens of Dermacentor variabilis, Ixodes scapularis, I. affinis, Amblyomma maculatum, and A. americanum were present on 49, 39, 17, seven, and two of the 53 Florida panthers, respectively, and comprised 36%, 55%, 7%, 1%, and < 1% of the 3,251 ticks collected from panthers. Ixodes scapularis, D. variabilis, and I. affinis were present on 61, 56, and 11 of the 85 bobcats respectively, and comprised 58%, 39%, and 2% of the 919 ticks collected. Amblyomma americanum and A. maculatum were found infrequently and comprised < 1% of the total ticks collected from bobcats. Only adult ticks were found on the cats, except for one D. variabilis nymph and three A. americanum nymphs that were found on bobcats.

Animals↗
PubMed1999

Atrial septal defects in Florida panthers.

Ostium secundum atrial septal defects (ASDs) were observed in six (3 M, 3 F) of 33 (20 M, 13 F) (18%) Florida panthers (Puma concolor coryi) necropsied by veterinary pathologists between 1985 and 1998. A seventh ASD was found in a female panther necropsied in the field and is included in the pathological description but not the prevalence of ASDs in Florida panthers. One panther (FP205) with severe ASD also had tricuspid valve dysplasia (TVD). Atrial septal defects and/or TVD are believed to have caused or contributed to the deaths of three (9%) Florida panthers in this study. Mean diameter +/- SD of ASDs was 9.0 +/- 4.7 mm (range 3 to 15 mm). Gross pathological changes attributed to ASDs/TVD in severely affected panthers (ASD > or = 10 mm) (n = 4) included mild right ventricular dilatation (n = 3) and hypertrophy (n = 2), mild to severe right atrial dilatation (n = 2), and acute pulmonary edema (n = 3). Panthers with mild ASDs (ASD < or = 5 mm) (n = 3) had no other detectable gross pathological changes associated with the ASDs. Histological examination of lungs of three panthers with severe ASDs revealed mild to moderate dilatation with fibrosis and smooth muscle atrophy of the tunica media of medium to large caliber arteries (n = 2), interstitial and/or pleural fibrosis (n = 2), perivascular fibrosis (n = 1), and acute to chronic edema (n = 3). Twenty-six necropsied panthers were examined one or more times while living; medical records were retrospectively evaluated. Antemortem radiographic, electrocardiographic, and echocardiographic examinations were performed on two panthers with severe ASDs (FP20 and FP205). Thoracic radiographic abnormalities in both included right heart enlargement, and in FP205 (severe ASD and TVD), mild pulmonary overperfusion. Electrocardiographic examination of FP205 revealed a right ventricular hypertrophy pattern, while FP205 had a normal electrocardiogram. Echocardiographic examination of FP20 revealed marked right atrial dilatation; a bubble contrast study indicated regurgitation across the tricuspid valve. Echocardiographic abnormalities in FP20 included right atrial and ventricular lilatation, atrial septal drop-out, and severe tricuspid regurgitation; non-selective angiography revealed significant left to right shunting across the ASD. All panthers with severe ASDs ausculted (n = 3) had systolic right or left-sided grade I-V/VI murmurs loudest at the heart base. All male panthers with ASDs (n = 3) (100%) and 9 of 17 (53%) male panthers without ASDs in this study were cryptorchid.

Animals↗
PubMed2001

Newcastle disease virus in double-crested cormorants in Alabama, Florida, and Mississippi.

In order to understand the epidemiology of Newcastle disease (ND) outbreaks in double-crested cormorants (Phalacrocorax auritus), a study was conducted on wintering migratory cormorants (P. a. auritus) in Alabama and Mississippi (USA) and non-migratory cormorants (P. a. floridanus) that breed in Florida (USA). Antibodies against ND virus were detected by the hemagglutination-inhibition method in sera from 86 of 183 (47%) migratory cormorants over-wintering in eight roosting sites in Alabama and Mississippi between November, 1997 and April, 1999. Titers ranged from 5 to 40. Antibody prevalences in sera collected from females in early winter (November and December) (26%) and late winter (February and March) (56%) were significantly different (P = 0.0007). None of 45 serum samples from 1- to 7-wk-old nestlings from 11 colonies in Florida during the 1997-98 and 1998-99 breeding seasons was positive. However, antibodies were detected in yolk samples from 98 of 126 (78%) eggs collected in these same colonies. Titers ranged from 4 to 256. The prevalence of antibodies in eggs collected from fresh-water colonies (63% prevalence, n = 30) and salt-water colonies (82% prevalence, n = 96) was significantly different (P = 0.041). ND virus was not isolated from tissues of 18 cormorants and cloacal and tracheal swabs from 202 cormorants collected in Alabama and Mississippi; virus was also not isolated from cloacal and tracheal swabs from 51 nestlings from Florida.

Alabama↗
PubMed2005

Validation and use of an indirect enzyme-linked immunosorbent assay for detection of antibodies to West Nile virus in American Alligators (Alligator mississippiensis) in Florida.

In October 2002, West Nile virus (WNV) was identified in farmed American alligators (Alligator mississippiensis) in Florida showing clinical signs and having microscopic lesions indicative of central nervous system disease. To perform seroepidemiologic studies, an indirect enzyme-linked immunosorbent assay (ELISA) was developed to determine exposure of captive and wild alligators to WNV. To validate the test, a group of WNV-seropositive and -seronegative alligators were identified at the affected farm using hemagglutination inhibition (HAI) and the plaque reduction neutralization test (PRNT). The indirect ELISA utilized a rabbit anti-alligator immunoglobulins polyclonal antibody as the secondary antibody, and inactivated WNV-infected Vero cells were used as the coating antigen. For all samples (n=58), the results of the ELISA were consistent with the HAI and PRNT findings. Plasma was collected from 669 free-ranging alligators from 21 sites across Florida in April and October 2003. Four samples collected in April and six in October were positive for WNV antibodies using HAI, PRNT, and the indirect ELISA. This indicated that wild alligators in Florida have been exposed to WNV. These findings can be used as a baseline for future surveys.

Alligators and Crocodiles↗
PubMed1999

Surveillance of morbidity during wildfires--Central Florida, 1998.

Several large wildfires occurred in Florida during June-July 1998, many involving both rural and urban areas in Brevard, Flagler, Orange, Putnam, Seminole, and Volusia counties. By July 22, a total of 2277 fires had burned 499,477 acres throughout the state (Florida Department of Community Affairs, unpublished data, 1998). On June 22, after receiving numerous phone calls from persons complaining of respiratory problems attributable to smoke, the Volusia County Health Department issued a public health alert advising persons with pre-existing pulmonary or cardiovascular conditions to avoid outdoor air in the vicinity of the fires. To determine whether certain medical conditions increased in frequency during the wildfires, the Volusia County Health Department and the Florida Department of Health initiated surveillance of selected conditions. This report summarizes the results of this investigation.

Disasters↗
PubMedDate not supplied

Medicaid eligibility expansion in Florida: effects on maternity care financing and the delivery system.

CONTEXT: In July 1989, the income limit on Medicaid eligibility for pregnant women in Florida was increased from 100% to 150% of the poverty level. This change may have led to substantial shifts in the financing of pregnancy-related care, and also may have had distinct effects on different providers in the health care delivery system. METHODS: Matched birth and death certificates, hospital discharge abstracts, Medicaid eligibility records and encounter records from county public health departments were used to estimate changes in the flows of funds and services by major payer groups during the period preceding the expansion (July 1988-June 1989) and for calendar year 1991. A total of 188,793 births in the first period and 193,292 in the second were examined. RESULTS: The number of births financed annually by Medicaid in Florida increased by 47% following the eligibility expansion, from 47,400 in 1988-1989 to 69,600 in 1991. This increase stemmed largely from covered births to women who otherwise would have been uninsured. Seventy-three percent of the additional 22,200 deliveries funded through Medicaid in 1991 are attributed to women who were eligible as a result of the expansions. The additional prenatal care financed by Medicaid was delivered almost entirely by county public health departments, which increased their capacity by more than 100%, from 177,000 visits in 1988-1989 to 433,000 in 1991. Medicaid payments for maternity care increased 39%, from $135 million to $187 million, while payments made by the uninsured dropped by 29%. These changes resulted in a 5% rise in hospital revenues, despite little change in the number of admissions. CONCLUSIONS: The Medicaid expansion benefited low-income pregnant women and hospitals in Florida. It is unknown whether the private delivery system would have accommodated the increased demand in the absence of the public health system response.

Birth Rate↗
PubMed1999

The conditions for state action in Florida's health-care market.

Despite the lack of confidence in government agencies to operate a nationalized health-care system in the United States, government agencies have significantly influenced the distribution and financing of health-care services in the market. Using the State of Florida as a case study, we examine the conditions under which a state health-care agency can consistently influence health-care market arrangements. We examined records from Florida's legislative sessions between 1965 and 1993 focusing on 27 legislative initiatives to involve the state's health-care agencies in the health-care services market. Using Boolean qualitative comparative analysis (QCA), we examined the conditions that facilitated or inhibited legislative policy initiatives for state action in Florida's health-care services market. The cohesiveness of state administrative agency and legislative leadership is of primary importance. Fragmented interests among health-care providers and fiscally legitimate policy positions, whether those of state agencies or health-care providers, are important enabling factors for state action.

Facility Regulation and Control↗
PubMed1999

Splitting fees or splitting hairs? Fee splitting and health care--the Florida experience.

Attorneys Jacobs and Goodman review the prohibitions against fee-splitting under Florida law and argue that Florida and other states need a clear statutory definition of prohibited activities. In addition, the authors argue that the Florida Board of Medicine has applied the prohibition against fee-splitting arbitrarily and in contrast to legal precedent set by the Second District Court of Appeals. Finally, the authors suggest that Minnesota provides clear legislative guidance on the issue of fee-splitting and that the approach adopted by Minnesota is more practical in today's complex health care reimbursement environment.

American Dental Association↗
PubMed2000

Rodent ectoparasites from two locations in northwestern Florida.

From Feb.-Apr. 1999, 19 species of ectoparasitic arthropods (2 sucking lice, 4 fleas, 4 ticks, 2 mesostigmatid mites, 5 chiggers, 2 fur mites) were recovered from 106 rodents belonging to 5 species (cotton mouse, Peromyscus gossypinus, n = 64; cotton rat, Sigmodon hispidus, n = 23; eastern woodrat, Neotoma floridana, n = 9; golden mouse, Ochrotomys nuttalli, n = 9; eastern gray squirrel, Sciurus carolinensis, n = 1) at Tall Timbers Research Station, Leon County, Florida. During the same period, 13 species of ectoparasites (2 sucking lice, 1 flea, 3 ticks, 3 mesostigmatid mites, 2 chiggers, 2 fur mites) were recovered from 57 rodents belonging to 3 species (S. hispidus, n = 40; black rat, Rattus rattus, n = 16; S. carolinensis, n = 1) from Panama City, Bay County, Florida. Noteworthy ectoparasite records include Ixodes minor from both sites, which extends the known geographical range of this tick, and Stenoponia americana from Tall Timbers that represents the second documented Florida record of this flea. Potential tick vectors (Dermacentor variabilis and Ixodes scapularis) of zoonotic pathogens (Rickettsia rickettsii and Borrelia burgdorferi) were collected at both sites. On S. hispidus, fleas were more prevalent at Tall Timbers but sucking lice, chiggers, ticks, mesostigmatid and listrophorid mites all were more prevalent at the Panama City site. Arthropods recovered from arboreal nests (n = 3) of O. nuttalli at Tall Timbers included 3 species of ectoparasites (1 tick, 2 laelapid mites).

Animals↗
PubMed2002

Wading birds as bioindicators of mercury contamination in Florida, USA: annual and geographic variation.

Mercury contamination in wetland biota is often dynamic, difficult to predict, and costly to track. In this paper, we present results from a six-year study of growing feathers of piscivorous birds as monitors of wetland Hg exposure in Florida, USA, wetlands. Between 1994 and 2000, we collected feathers of growing great egret (Ardea alba) nestlings from colonies in the freshwater Everglades of southern Florida, and during 1998, feathers were collected from chicks of both great egrets and white ibises (Eudocimus albus) at a variety of colonies throughout peninsular Florida. Coastal colonies showed significantly lower feather Hg concentrations than did inland sites. Within the Everglades, we found significant effects of both geographic location and year on age-adjusted mean total Hg concentrations in feathers. Over the course of our study, Everglades colonies maintained their Hg concentration rankings relative to one another, but all showed strongly declining Hg concentrations (mean of 73% averaged across colonies, between 1994 and 2000). Using a previously established predictive relationship between Hg consumption in food and feather Hg for great egrets, we estimated that Hg concentrations in the aggregate diet of egrets have been reduced by an average of 67%. We conclude that the Everglades has undergone a biologically significant decline in Hg availability in the wetland food web, possibly because of decreased local inputs.

Animals↗